Considerations for Resuming Global Surgery Outreach Programs During and After the COVID-19 Pandemic

Stoehr, Jenna Rose; Jahromi, Alireza Hamidian; Chu, Quyen D.; Zibari, Gazi B.; Gosain, Arun K.

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has disrupted the delivery of safe surgical care worldwide. One specific aspect of global surgical care that has been severely limited is the ability for physicians and trainees to participate in global surgical outreach programs (GSOPs) in low- and middle-income countries (LMICs). METHODS: A narrative review of the literature regarding GSOPs during the COVID-19 pandemic was performed. Factors that must be considered in the reinstatement of GSOPs were identified and suggestions to address them were provided based on the available literature and the experiences of the senior authors. RESULTS: As GSOPs were cancelled at the start of the pandemic, many academic surgeons turned to digital solutions in order to continue to engage with LMIC partners. With the advent of COVID-19 vaccines and improved access to testing and treatment worldwide, the recommencement of GSOPs may begin to be considered. Important considerations prior to initiation include vaccine and testing availability for visiting providers, local staff, and patients, local hospital capacity, staff and equipment shortages, and the characteristics of the patient population and visiting providers. Region- and country-specific factors, including local infection rates and concomitant health crises, must also be taken into account. Expansion of digital collaborative efforts may further deepen international connections and promote sustainable models of care. CONCLUSIONS: With careful consideration, GSOPs may begin to be safely restarted in the near future. The current paper evaluates individual factors that must be considered to safely restart GSOPs as the COVID-19 pandemic is better controlled.